Medicine and Health Sciences Commons^™

Early Childhood Support Specialist Evaluation Report, Emilie Swenson Msw, Rachel Gallo Mph

Children, Youth, & Families

The Early Childhood Support Specialist (ECSS) at MaineHealth builds relationships with families who have children aged birth to three, a timeframe when infants and toddlers are rapidly developing, learning, and benefiting from family and community connections. The ECSS assesses a family’s strengths and needs to understand how that family can be supported and connected. The ECSS connects families to resources, provides referrals, coaches families on children’s social and emotional development, and generally serves as a point of contact to assist families with social, emotional, and medical needs. Ultimately, the intended outcome of this model is to increase family connections, decrease …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Improving Nursing Education Curriculum As A Tool For Strengthening The Nurse–Client Relationships In Maternal And Child Healthcare: Insights From A Human-Centered Design Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background. There are growing evidence of poor nurse–client relationships in maternal and child health (MCH). The nursing curriculum forms an important entry point for strengthening such relationships, consequently improving client satisfaction with nurses' competencies, confidence in the formal healthcare system, healthcare-seeking practices, continuity with care, and MCH outcomes.

Objective. MCH nurses and clients were invited to design an intervention package (prototype) to improve nurse–client relationships using a human-centered design (HCD) approach.

Methods. A multi-step HCD approach was employed to first examine the contributors of poor nurse–client relationships using nine focus group discussions with nurses and clients and 12 key informant …

My Baby, My Move+: Feasibility Of A Community Prenatal Wellbeing Intervention, Jenn A. Leiferman, Rachael Lacy, Jessica Walls, Charlotte V. Farewell, Mary K. Dinger, Danielle Symons Downs, Sarah S. Farrabi, Jennifer L. Huberty, James F. Paulson

Psychology Faculty Publications

Background

Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG.

Methods

Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 …

Perspective: Organic Food Consumption During Pregnancy And The Potential Effects On Maternal And Offspring Health, Cynthia L. Curl, Annica Balentine

Public Health and Population Science Faculty Publications and Presentations

Pregnancy represents a critical window for both maternal and child health. Previous studies have shown that the consumption of an organic diet during pregnancy can reduce pesticide exposure compared with the consumption of a conventional diet. It is possible that this could, in turn, improve pregnancy outcomes, because maternal pesticide exposure during pregnancy has been associated with increased risk of pregnancy complications. Organic foods are produced by methods that comply with organic standards, generally restricting the use of agrochemicals, such as synthetic pesticides. In the past few decades, the global demand for organic foods has increased drastically, driven in large …

Forming The Perception Of Wic Infant Feeding Recommendations: A Qualitative Study, Emily Fisher, Kathryn Wouk, Priyanka Patel, Chuanyi Tang, Qi Zhang

Community & Environmental Health Faculty Publications

Nearly half of newborns in the United States are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Promoting breastfeeding is a programmatic priority, although formula vouchers are provided for those who do not exclusively breastfeed. Previous literature suggests that participant perception of WIC’s breastfeeding recommendations is a significant factor predicting breastfeeding initiation, duration, and exclusivity outcomes. However, little is known about how participants’ perceptions of WIC’s breastfeeding recommendations are formed. To address this knowledge gap, we conducted a qualitative pilot study in Nevada, interviewing 10 postpartum WIC mothers and 12 WIC staff who had interacted …

Virtual Home Visits During Covid-19 Pandemic: Mothers' And Home Visitors' Perspectives, Abdullah Al-Taiar, Michele A. Kekeh, Stephanie Ewers, Amy L. Prusinski, Kimberly J. Alombro, Nancy Welch

Community & Environmental Health Faculty Publications

Background

The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation.

Methods

Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received …

Editors’ Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Editor's Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

These Editors' Notes introduce the first special issue of the Journal of Health Disparities Research and Practice based on the work the National Maternal Health Research Network.

Elucidating Mechanisms Influencing Maternal Postpartum Health: The Protective Benefits Of Breastfeeding And Associations With Allostatic Load, Experiences Of Stress, And Resiliency, Bi-Sek J. Hsiao

Doctoral Dissertations

Research has established breastfeeding as protective of maternal health, but little is known about the ways breastfeeding interacts with chronic stress pathways and interfaces with stressors such as discrimination and neighborhood deprivation, which are salient in the experiences of many marginalized communities. This research addresses these knowledge gaps through secondary analyses of prospective cohort data generated by the Community Child Health Research Network through Community Based Participatory Research processes. Analytical samples were derived from 2510 postpartum women from five regions in the U.S. who self-identified as Black, Hispanic, or White. Study 1 investigated and found an inverse association between breastfeeding …

Shinetagantsi: Un Caso De La Alimentación Materna E Infantil Y Medicina Intercultural Durante Lactancia En La Comunidad Nativa De Palotoa Teparo, Layne Scopano

Independent Study Project (ISP) Collection

Con un enfoque antropológico, esta investigación analiza las percepciones del cuidado desde los sistemas médicos occidentales y la medicina tradicional de las madres de la comunidad nativa de Palotoa Teparo en la Amazonía peruana en lo que respecta a la nutrición durante la lactancia. Los resultados de este estudio, obtenidos a través de entrevistas semiestructuradas y observación directa e indirecta, permiten describir el estado nutricional de las madres de Palotoa Teparo durante la lactancia y su relación con la nutrición infantil, señalar las prácticas de salud, tanto occidental como tradicional, relevantes para el estado nutricional de las madres y los …

Clinicians' Perceptions Of The Health Status Of Formerly Detained Immigrants, Kathryn Hampton, Ranit Mishori, Marsha Griffin, Claire Hillier, Elizabeth Pirrotta, Nancy E. Wang

School of Medicine Publications and Presentations

Background: In the past decade, the U.S. immigration detention system regularly detained more than 30,000 people per day; in 2019 prior to the pandemic, the daily detention population exceeded 52,000 people. Inhumane detention conditions have been documented by internal government watchdogs, and news media and human rights groups who have observed over-crowding, poor hygiene and sanitation and poor and delayed medical care, as well as verbal, physical and sexual abuse.

Methods: This study surveyed health professionals across the United States who had provided care for immigrants who were recently released from immigration detention to assess clinician perceptions about the adverse …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Conflict, Extremism, Resilience And Peace In South Asia; Can Covid-19 Provide A Bridge For Peace And Rapprochement?, Zulfiqar Ahmed Bhutta, Arun Mitra, Afsah Salman, Fawad Akbari, Suraya Dalil, Fyezah Jehan, Mushtaque Chowdhury, Saroj Jayasinghe, Purnima Menon, Samiran Nundy

Institute for Global Health and Development

Abstract, issue, and pagination are not provided by the author/publisher

Workforce Assessment: Measuring The Impacts Of Covid-19 On The Maternal And Child Health Workforce, Ashleigh M. Sutphen

Capstone Experience

Workforce assessments provide an opportunity to assess, evaluate, and identify the needs of a particular workforce. The use of workforce assessments in the field of maternal and child health (MCH) has been an ongoing and a strongly supported effort by the Health Resources & Services Administration: Maternal and Child Health Bureau (MCHB). The maternal and child health workforce is responsible for providing essential public health services to some of the most vulnerable populations such as mothers, children, and people living with disabilities. Thus, the continuation of providing these essential public health services is critical – even in the midst of …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Researching The Delivery Of Health And Nutrition Interventions For Women And Children In The Context Of Armed Conflict: Lessons On Research Challenges And Strategies From Branch Consortium Case Studies Of Somalia, Mali, Pakistan And Afghanistan, Michelle F. Gaffey, Anushka Ataullahjan, Jai K. Das, Mohammed Shafiq Mirzazada, Moctar Tounkara, Abdirisak A. Dalmar, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The BRANCH Consortium recently conducted 10 mixed-methods case studies to investigate the provision of health and nutrition interventions for women and children in conflict-affected countries, aiming to better understand the dominant influences on humanitarian health actors' programmatic decision-making and how such actors surmount intervention delivery barriers. In this paper, the research challenges encountered and the mitigating strategies employed by the case study investigators in four of the BRANCH case study contexts are discussed: Somalia, Mali, Pakistan and Afghanistan.
Discussion: Many of the encountered research challenges were anticipated, with investigators adopting mitigation strategies in advance or early on, but others …

Abstracts From The 26th Annual Health Care Systems Research Network Conference, April 8–10, 2020

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of community-based care delivery systems with a shared mission to improve health and health care through research. The network’s annual conference serves as a forum for attendees to disseminate study findings, stimulate collaborations, and share insights about conducting research in real-world care settings. Although this year’s live conference was cancelled to help slow the spread of COVID-19, the oral and poster abstracts accepted for presentation at HCSRN 2020 are published in this open access supplement to Volume 7, Issue 1 of the Journal of Patient-Centered Research and Reviews, the …

Why Do Women Deliver Where They Had Not Planned To Go? A Qualitative Study From Peri-Urban Nairobi Kenya., V. Naanyu, V. Mujumdar, C. Ahearn, M. Mcconnell, J. Cohen

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: In urban Kenya, couples face a wide variety of choices for delivery options; however, many women end up delivering in different facilities from those they had intended while pregnant. One potential consequence of this is delivering in facilities that do not meet minimum quality standards and lack the capacity to provide treatment for obstetric and neonatal complications.

METHODS: This study investigated why women in peri-urban Nairobi, Kenya deliver in facilities they had not intended to use. We used 60 in-depth audio-recorded interviews in which mothers shared their experiences 2-6 months after delivery. Descriptive statistics were used to summarize socio-demographic …

The Increase In Neonatal Abstinence Syndrome From Opioids Affects Us All, Sean Withington, Shannon M. Monnat

Population Health Research Brief Series

Opioid use during pregnancy has increased dramatically in the U.S. over the past decade, leading to a surge in cases of neonatal abstinence syndrome (NAS) – babies born dependent on opioids. This issue brief discusses the impacts of NAS in the U.S. and ways we can address this important population health problem.

Abstracts From The 25th Annual Health Care Systems Research Network Conference, April 8–10, 2019, Portland, Oregon

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of nonprofit health systems with embedded research departments whose scientists are dedicated to public domain research. The network’s annual conference serves as a forum for research teams to disseminate study findings, stimulate new collaborations, and share insights about conducting research in real-world care settings. Abstracts accepted for presentation at HCSRN 2019 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official scientific journal of the conference.

The Salt Between The Beans: A Qualitative Study Of The Role Of Auxiliary Midwives In A Hard-To-Reach Area Of Myanmar, Kyu Kyu Than, Stanley Luchters, Khaing Nwe Tin, Thazin La, James Beeson, Alison Morgan

Population Health, East Africa

Background: Auxiliary Midwives (AMWs) are unpaid volunteer health workers assisting qualified paid midwives in maternal and child health care mainly in hard-to-reach areas of Myanmar. This paper describes the relationship between AMWs and the health system in providing maternal and child services as perceived by the community, AMWs themselves and health care providers in one remote township of Myanmar.

Method: A qualitative study was conducted in Ngape Township, Myanmar. A total of 15 focus group discussions with midwives, AMWs, community members and mothers were conducted. Ten key informant interviews were performed with national, district and township level health planners and …

Examining The Impact Of Couple Relationship Factors On Male Engagement Pregnancy Health And Communal Coping, Pamela Musoke

All ETDs from UAB

Focusing on male partner engagement in HIV prevention is an important aspect of intervention and policy development and implementation within the sub-Saharan African context. However, engaging male partners safely and effectively to improve the impact and sustainability of HIV prevention modalities remains challenging due to continued impact of traditional gender roles that may affect the willingness and confidence to engage in pregnancy health. Additionally, the lack of knowledge of how best to engage in pregnancy health beyond financial support makes it difficult for male partners to engage. This dissertation’s overall aim is to explore aspects of male partner engagement's influences …

Provider Perspectives On Demand Creation For Maternal Vaccines In Kenya, Irina Bergenfeld, Stacy W. Nganga, Courtni A. Andrews, Vincent L. Fenimore, Nancy A. Otieno, Sandra S. Chaves, Jennifer R. Verani, Marc-Alain Widdowson, Winnie N. Wairimu, Susan N. Wandera, Raphael O. Atito, Maxwell O. Adero, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Background. Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods. Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview …

Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie

Walden Dissertations and Doctoral Studies

Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …

Three Essays On Maternal And Child Health, Mandar V. Bodas

Theses and Dissertations

This dissertation is a collection of three separate essays on the health of women and children. In the first essay, I along with my co-authors, analyzed the impact of two large, national-level health policies (the Janani Suraksha Yojana (JSY) and the National Rural Health Mission (NRHM)) on maternal health outcomes (proportion of institutional deliveries) in India. We used data from the India Human Development Survey (IHDS) and found that the JSY and the NRHM had a greater impact on institutional deliveries in high-focus states. We also found that the conditions of the public health facilities, did not change after the …

Prenatal Depression Screening Among A Diverse Healthy Start Population., Evangeline Pierce

Electronic Theses and Dissertations

Prenatal depression has been associated with adverse outcomes for both pregnant women and infants. Data was studied from Healthy Start (n=1093). Healthy Start participants were screened for depression using the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Data reported included birthweight, gestational length, ethnicity, and sociodemographic variables. No statistically significant association was found between a positive EPDS screen and birthweight-low/normal (OR 1.02 [95% CI 0.53, 1.70]), birthweight-abnormal (OR 1.02 [95% CI 0.53, 1.70], or gestation-preterm/term (OR 1.29 [95% CI 0.68, 2.45]). An association was observed between a positive screen and race, ethnicity by region of origin, immigrant status, English as …

Exploring The Life Course Perspective In Maternal And Child Health Through Community-Based Participatory Focus Groups: Social Risks Assessment, Abraham Salinas-Miranda, Lindsey M. King, Hamisu M. Salihu, Estrellita "Lo" Berry, Deborah Austin, Susan Nash, Kenneth Scarborough, Evangeline Best, Lillian Cox, Georgette King, Carrie Hepburn, Conchita Burpee, Eugene Richardson, Marlo Ducket, Richard Briscoe, Julie Baldwin

Journal of Health Disparities Research and Practice

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas.

Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …